If a person has never ridden on a tipcart over [28]wild, backcountry roads, then telling him about it is pointless: all the same he won’t understand. And for the person who has done it, well, I don’t want to remind him of it.

I’ll say briefly: It took a full 24 hours for the cart driver and I to travel the 40 versts[29] that separate the district town of Grachevka from Murya Hospital. It was uncanny how we arrived almost to the minute: At two pm on September 16, 1917 we were at the last silo on the edge of that most wonderful town of Grachevka and on September 17^th of that same, unforgettable year at five minutes past two o’clock in the afternoon, I stood on dying grass, beaten down and sodden with September rains, in the courtyard of Murya Hospital. I stood in the courtyard, legs ossified, dazed, I mentally flipped through the pages of my text books, stupidly trying to recall, if such an ailment did indeed exist or if I had dreamt of it last night in the village of Grabilovka – that illness where a man’s limbs go rigid? What is its damned name in Latin? Each of my muscles ached with an intolerable pain, like that of a toothache. I won’t even mention my toes. They no longer moved in my boots, instead they lay peacefully, like wooden stumps. I confess, in a burst of disheartened passion I whispered curses on the medical profession and the entrance application I submitted to the University Rector five years ago. During this entire time, it drizzled from above as if through a sieve. My coat welled up like a sponge. With the fingers of my right hand, I futilely tried to grasp the handle of the suitcase and finally I spat on the wet grass in frustration. My fingers unable to grip anything, my mind, filled with all sorts of facts from interesting medical textbooks, I finally remembered the illness – palsy…

”Paralysis,” I desperately, the devil knows why, said to myself.

̶

– T..t… travelling on your roads, – I said with blue, wooden lips, – takes a lot of g… getting used to…

I said spitefully, for some reason, to the cart driver, even though the state of the road wasn’t his fault.

– Ah, comrade Doctor, – retorted the coachman, his lips barely moving beneath a pale mustache, – I’ve been traveling this road for 15 years and I still can’t get used to it.

I shuddered, dismally gazing back at the white, peeling paint of the two-story building; at the unbleached log walls of the feldsher’s cottage; at my own future residence: a two-story, straight-lined house, with mysterious, coffin-like windows. I slowly sighed. And then, dully, there came to me not Latin words, but a sweet phrase sung, in my dazed-from-the-journey-and-cold mind, by a plump tenor wearing blue tights:

“I greet you home, so chaste and pure…“[30]

– Goodbye, until we meet again gold and red swathed stage of the Bolshoi theater, goodbye Moscow and your shop windows, ah, goodbye.

“I’ll put on my overcoat next time,” I thought in baleful forsakenness as I yanked the suitcase by the straps with my stiff hands. But next time it will already be October. Maybe I should wear two overcoats. I certainly won’t return before a month passes; I won’t travel back to Grachevka. Think of it – I had to stay the night! We traveled twenty versts and night fell… darkness like a tomb… night… we had to stay the night in Grabilovke, a school teacher took us in… and then this morning we left at 7 in the morning. And, God, how we traveled. Slower than a pedestrian. One wheel caught in a pothole, the other spinning in the air, my suitcase falling on my feet – bump – wobbling to the side, then to the other, now sliding forward, now back. And from above the drizzle drizzling, freezing your bones. How could I imagine that in the middle of a foul, sour, September, a man could freeze in a field the same as in the midst of a bitter winter?! Ah, it seems that he can. And while you die a slow death, you see mile after mile of the same thing. On the right – humpy picked over fields, to the left – a straggly grove, and across from that ragged, graying izbas[31] – maybe five or six of them. And seemingly not a living soul to be found within them. Silence, silence all around.”

At last, the suitcase fell over. The driver leaned over his stomach and shoved the case directly at me. I wanted to hold it by the strap, but my swollen hands refused to work, and my companion, stuffed with books and all manner of junk, crashed to the ground, striking my legs.

– Oh Lord – began the driver, startled, but I didn’t make any complaints- my legs were already good for nothing but to be thrown away.

– Hey, anyone here? Hey! – yelled the driver beating his hands like a rooster his wings. -Hey, I’ve brought the doctor!

At this, faces appeared in the dark glass of the feldsher’s cottage, pressing into the glass. The door banged and a man in a ragged coat and boots hobbled towards me across the grass. He hurriedly and respectfully removed his cap, ran two steps toward me, smiled embarrassedly for some reason, and hoarsely greeted me.

– Greetings, comrade doctor.

– And who are you? – I asked.

– Egorich – the man introduced himself, – the watchman here. We have been waiting for you, waiting…

At this he grabbed onto the suitcase, threw it up onto his shoulder and carried it off. I limped after him, unsuccessfully trying to shove a hand into my trouser pocket to pull out my billfold.

When it comes down to it, a man needs very little. But above all else he needs fire. Travelling through the Murya back country, I remembered how, back in Moscow, I had vowed to conduct myself respectably. My youthful appearance betrayed me at first sight. I was introduced to everyone:

– Doctor So and So.

And without fail, every single person raised his eyebrows and asked:

– Are you really? But I was sure you must still be a student.

– No, I completed my studies, – I sullenly replied, but thinking to myself: “I must start wearing glasses, that’s what I must do.” But donning glasses served no purpose, my eyes being healthy and unclouded by life experience. Unable to ward off the sweet, condescending smiles with the help of glasses, I instead tried to develop an especially authoritative habit. I tried to speak in a measured and weighty tone, to constrain all possible impatient movements. To not run, as people of twenty-three and who have just completed university might, but to walk. I understand now, with the hindsight of many years, that it all came across quite poorly.

At the present moment, I had violated my unwritten code of behavior. I wore a single sock and sat huddled in the kitchen, not tucked away in a study somewhere, but in the kitchen like some fire worshiper eagerly reaching for the blazing birch logs in the stove.

To my left lay a turned over washtub and on it my boots. Alongside them rested a rooster plucked bare, his neck bloodstained, and his many, colored breast feathers piled beside him. Despite my numbed state, I had still managed to do a great number of things which required a great deal of effort. I confirmed Aksinya Vostronosaya, the wife of Yegorich, in her duties as my cook. The rooster, as a result of this, died by her hand. I was obliged to eat him. I met everyone. The feldsher[32] was called Demyan Lukich, the midwives – Pelagea Ivanovna and Anna Nikolaevna. I managed to tour the hospital and was struck by the sheer quantity of medical instruments. Not only were there lots of instruments, I was forced to admit (only to myself, of course) that I didn’t have a clue as to what use most of these shining, virgin tools could be put to. Not only had I never held them in my hand, but I openly admit that I had never before even laid eyes upon them.

– Hmm – I intoned meaningfully, – you have an exquisite stock of medical instruments. Hmm…

– Of course, it is – Demyan Lukich sweetly noted – it is the result of the efforts of your predecessor, Leopold Leopoldovich. He operated from morning to night.

I broke into a cold sweat and stared dully at the polished, mirrored cabinets.

We left to walk through the empty wards and I was certain that they could easily accommodate 40 people.

– Leopold Leopoldovich sometimes tended as many as 50, – Demyan Lukich assured me, and Anna Nikolaevna, a woman with a crown of grey hair, for some reason added:

– You, Doctor, are so young… so young… It is immediately noticeable. You look like a student.

“Curse you devil” I thought – How alike you all are, honestly.”

But muttering through gritted teeth:

– Hmm, no, I…that is.. yes, I am young.

Then we went down to the pharmacy and I immediately saw that it had everything necessary and more besides. The two dark rooms smelled of herbs and the shelves were loaded with everything imaginable. There were even patented, foreign medicines, and is it necessary to add that I had never heard even a rumor of them before?

– Leopold Leopoldovich ordered all these – Pelagea Ivanovna proudly announced.

“This Leopold was a real genius”, I thought filled with respect for the enigmatic Leopold who had left the quiet village of Murya.

Besides fire, a man needs to be able to adapt to his surroundings. The rooster had long ago been eaten by me; the mattress – stuffed with straw by Yegorich and made up with bedding; a lamp set to burn in the study – in my residence. I sat spellbound staring at the third achievement of the legendary Leopold: a bookshelf filled to breaking with books. A single series on surgery in both Russian and German ran on for some thirty volumes. And therapeutics! And the wonderful leather-bound atlases!

Evening was coming and I was beginning to adapt.

“It’s not my fault – I stubbornly and excruciatingly repeated to myself, – I have my diploma – fifteen A’s, I even told them that I wanted to work as an assistant doctor. No. They smiled and said: “You’ll adapt”. Here you are and get used to it. And what if they bring in a hernia? Tell me, how am I supposed to “adapt” to a hernia? And what’s more, how will a hernia patient fare under my treatment? Will he adapt to that other world? (At this a shiver ran down my spine)…

And a septic appendix? A diptheric croup amongst the village boys? When is a tracheotomy warranted? But even without a tracheotomy I won’t know what I’m doing… or a birth! A birth – how could I forget! Posterior presentation. What am I going to do? What? I’m such an idiot! I should have refused this position! I needed to! They would have found some other Leopold.”

In the twilight, I anxiously paced the study.

When I drew near the lamp, I saw my pallid face alongside the flicking flame framed by the boundless darkness of fields beyond the windowpane. “I look like False Dmitry,” I foolishly thought and went to sit at the table again.

I sat worrying for nigh on two hours until my nerves could no longer bear up under the cumulations of my fearful imaginings. I began to calm myself and even come up with some plans of action.

Look, they say there are very few patients being brought in at the moment, in the villages they are breaking flax, far from the roads…

“They’ll bring you a hernia patient,” the dour voice in my head interrupted, – a person with a cold (an altogether manageable illness) won’t come, but a hernia, that they’ll bring you, do calm yourself good doctor”.

The voice wasn’t stupid, was it? I shuddered.

“Shut up, – I told the voice, – it won’t necessarily be a hernia. No need for a nervous breakdown. Now that I’ve started, there’s no turning back.”

“In for the penny, in for the pound” snidely retorted the voice.

Well, I… I won’t do a thing without my medical book… If I have to write a prescription, I can think about what to do while washing my hands. My reference manual will be open and laying on top of the appointment book. I’ll prescribe useful, simple medicines. Like, for example, a 5mg sachet of sodium salicylate[33] three times a day…

“You can prescribe baking soda!” my internal companion mocked.

What does baking soda have to do with anything? I can prescribe syrup of ipecac. 180cc. or maybe 200cc. There, watch me do that.

I sat down alone by the lamp and halfheartedly flipped through a pharmaceutical manual, though no one currently needed a prescription of ipecac syrup[34], and so happened to run across “insipin”. While similar to essence of sulpheric quininic acid…it has ...